超声评价高血压对左心室舒张功能和动脉顺应性的影响

摘要

目的 应用超声成像技术评价高血压对左室(LV)舒张功能及动脉顺应性的影响.方法 原发性高血压(EH)患者70例分为LV构型异常(A组,28例)和正常(B组,42例)两组.70例正常人作为对照组(C组).A、B组应用超声心动图测定左房室内径、LV壁厚度和相对室壁厚度、LV质量指数、LV射血分数；记录二尖瓣口的血流频谱(E、A)和二尖瓣环的组织运动速度(e'、a'),计算E／e’；测左侧颈总动脉内中膜厚度、最大及最小径,计算颈动脉顺应性(AC)、血管僵硬参数(β)及压力应变弹性系数(Ep).结果 A组的左房、室较B组及C组扩大(P＜0.05).A、B组E／e'高于C组(P＜0.05),e’／a’低于C组(P＜0.05),A组E/A低于B组和C组(P＜0.05).A、B组IMT、β、Ep高于C组,AC低于C组(P＜0.05)；A组的βEp高于B组(P＜0.05).结论 EH可致LV舒张功能及动脉顺应性降低；组织多普勒评价LV舒张功能优于二尖瓣血流频谱.%Objective To evaluate the impact of hypertension on left ventricular (LV) diastolic function and arterial compliance with ultrasound imaging. Methods Seventy patients with essential hypertension(EH) were divided into two groups of A(28 cases,with abnormal LV geometry) and B (42 cases.with normal LV geometry). Seventy healthy people were taken as the controls (group C). The left atrial(LA) and LV diameters, wall thickness and relative wall thickness,left ventricular mass index and left ventricular ejection fraction were measured by echocardiography. The mitral valve flow pattern(E,A) and mitral annulus tissue velocity(e',a') were recorded and E/e' was calculated. The left common carotid artery intima-media thickness and carotid diameter were measured and the carotid arterial compliance(AC), vascular stiffness parameters(β) and pressure-strain elasticity modulus(Ep) were calculated. Results LA and LV of group A were dilated compared with those of group B and group C(P<0. 05). The E/e' was higher, but e'/a' was lower, in groups of A and B than those in group C(P<0. 05). The values of IMT,β and Ep were higher, while AC was lower, in groups of A and B than those in group C(P<0. 05). The values of β and Ep were higher in group A than those in group B(P<0. 05). Conclusion Hypertension would impair LV diastolic function and arterial compliance. LV and artery might interact as a function coupling. β)Tissue Doppler imaging is better than mitral valve blood flow spectrum in evaluating LV diastolic function.